Leadership

How this family doctor finds satisfaction in juggling roles

Sumi Sexton, MD, grew up with two parents who were physicians, so her interest in the health field did not come as a big surprise. It was not until her third year of medical school, though, that she discovered her passion for family medicine.

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Up until that point, she had thought her specialty would be psychiatry, but she realized she wanted to practice a primary care specialty that would allow her to pursue a wide range of clinical interests. Dr. Sexton also wanted to be in a position that forced her to constantly learn new things.

Today, she is doing just that.

Dr. Sexton is a family physician with Premier Primary Care Physicians in Arlington, Virginia, and her practice is a proud member of Privia Medical Group—an AMA Health System Program partner. She also serves as the editor-in-chief of American Family Physician, wrote Pacifiers Anonymous: How to Kick the Pacifier or Thumb Sucking Habit, and is an associate professor at the Georgetown University School of Medicine. Her particular interest areas include adolescent medicine, newborn and infant care, and women’s health.

“Sometimes family medicine is undervalued in terms of caring for the person as a whole and being able to treat and help with many different things,” Dr. Sexton says. “We’re not just a gatekeeper and referral center. We’re about caring for the whole person and, when possible, knowing their family, which really makes a difference.”

When a doctor is able to learn and understand a patient’s family history, it can impact recommended treatment or care. When patients separate out symptoms from one another—often unintentionally—having insight into the family can sometimes serve as the bond that brings those symptoms together.

“Psychosocially, it makes a huge impact,” Dr. Sexton says. “It makes it more interesting for me because I’m able to form genuine connections with my patients, and they feel they can trust me because they’ve been coming to me for a while and they know I have their best interest at heart.”

Talking with adolescents

Many of the patients Dr. Sexton sees are teenagers, and over the course of her 20-plus-year career, she’s seen this patient population evolve. Children and teenagers today are far more accepting with regards to sexuality and gender identification, she says, and overall there is more of an openness in their attitudes. As they have evolved, though, so too have their risk factors.

Today Dr. Sexton spends much of her time talking with kids about social media and screen time.

A 2018 Pew Research Center report found that 95% of teenagers have access to a smartphone, and 45% said they are online “almost constantly.” While Dr. Sexton readily acknowledges there are some benefits to social media, she also warned that, as with anything in life, too much of one thing can lead to problems.

“Spending a lot of time on social media and not actually having enough human interactions can lead to lingering feelings of inadequacy because of what others are posting,” Dr. Sexton says.

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Vaping is another major topic Dr. Sexton finds herself frequently addressing. The 2019 National Youth Tobacco Survey from the Centers for Disease Control and Prevention found that one in four U.S. high school students and one in 10 middle school students used e-cigarettes in the past 30 days. These statistics are particularly alarming since people younger than 25 are at more of a risk from nicotine because of how it impacts a developing brain.

Few teenage patients who talk with Dr. Sexton openly admit to vaping or trouble with social media—be it overuse or online bullying. To get information, she frequently relies on asking open-ended questions and reassuring confidentiality, the longstanding relationship she’s been able to build with the patient and family, comments from parents, or a detail she notices on an exam.

Concerns about burnout

Dr. Sexton’s varied responsibilities could easily lead many in a similar position to burnout, and she confessed that juggling her roles is not easy.

“I realized long ago that there are only 24 hours in a day, and it matters what I choose to do with those hours,” she says. “In the end, all of us are faced with the same time constraints. I’m a good multitasker, and when I get overwhelmed, I take a deep breath and say, ‘Just do what I can do.’”

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A recent online survey by the Medscape news site found a burnout rate of 46% among family physicians. Dr. Sexton said administrative burdens are driving that sobering statistic. The sense of being overwhelmed by paperwork detracts from time in the exam room.

“If the time needed to take care of families and getting to know people is slowly chipped away because you’re focused on how am I going to get this chart done so I get paid, that’s not a happy situation,” she says.

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For Dr. Sexton, one of the most effective ways to prevent burnout is through her editorial role with American Family Physician. She’s been involved with the twice-a-month journal since she was a medical student and took on the editor-in-chief role in 2018.

Being a part of Privia has also helped. Since her practice joined in 2014, Dr. Sexton and her team have benefitted from a more robust EHR system and other technological upgrades such as virtual visits and virtual assistants—the latter is an upcoming pilot project to help cut documentation overload. Having a national network of doctors to connect and collaborate with has been valuable, as has the autonomy Privia provides.

“We intentionally made the decision to partner with other groups under an umbrella … but we did not want to be absorbed,” Dr. Sexton said. “We work together to make changes in medicine and hopefully improve quality care for our patients, but we make our own decisions on a day-to-day basis.”

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